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A randomized, open-label trial of continuous versus interrupted etanercept therapy in the treatment of psoriasis.
J Am Acad Dermatol. 2007 Apr; 56(4):598-603.JA

Abstract

BACKGROUND

Although etanercept is used as a continuous therapy for moderate to severe plaque psoriasis, intermittent use may be necessary in some instances.

OBJECTIVE

In this randomized, open-label study, we evaluated the effectiveness and safety of continuous versus interrupted etanercept therapy.

METHODS

All patients received uninterrupted etanercept 50 mg twice weekly during the first 12 weeks, followed by either continuous (n = 1272) or interrupted (n = 1274) etanercept 50 mg once weekly in the next 12 weeks. The primary effectiveness end point was the proportion of responders (those who achieved a Physician's Global Assessment [PGA] score <or=2 and improvement from baseline) at week 24. Secondary end points included the PGA "clear/almost clear" status, the PGA Scalp Psoriasis score, and the Dermatology Life Quality Index. A modified intent-to-treat analysis was performed.

RESULTS

At week 12, comparable high proportions of responders were reported in the continuous (71.3%) and interrupted (72.0%) arms. However, the proportion of responders at week 24 was greater in the continuous group than in the interrupted group (71.0% vs 59.5%; P < .0001). Similar results were observed in secondary end points. The mean number of etanercept doses (1 dose = 50 mg) received by patients in the continuous group was 33.4, compared with 28.0 in the interrupted group. Etanercept was well tolerated in both treatment arms.

LIMITATIONS

We examined one round of discontinuation and re-treatment; interrupted therapy provided less total medication to responding patients.

CONCLUSIONS

Continuous and interrupted etanercept therapy was effective and generally well tolerated in patients with psoriasis, with greater improvements observed in the continuous arm at week 24. Most patients regained their response after reinitiation of etanercept.

Authors+Show Affiliations

Arlington Center for Dermatology, TX 76011, USA. acdermatology@yahoo.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article
Randomized Controlled Trial
Research Support, Non-U.S. Gov't

Language

eng

PubMed ID

17113190

Citation

Moore, Angela, et al. "A Randomized, Open-label Trial of Continuous Versus Interrupted Etanercept Therapy in the Treatment of Psoriasis." Journal of the American Academy of Dermatology, vol. 56, no. 4, 2007, pp. 598-603.
Moore A, Gordon KB, Kang S, et al. A randomized, open-label trial of continuous versus interrupted etanercept therapy in the treatment of psoriasis. J Am Acad Dermatol. 2007;56(4):598-603.
Moore, A., Gordon, K. B., Kang, S., Gottlieb, A., Freundlich, B., Xia, H. A., & Stevens, S. R. (2007). A randomized, open-label trial of continuous versus interrupted etanercept therapy in the treatment of psoriasis. Journal of the American Academy of Dermatology, 56(4), 598-603.
Moore A, et al. A Randomized, Open-label Trial of Continuous Versus Interrupted Etanercept Therapy in the Treatment of Psoriasis. J Am Acad Dermatol. 2007;56(4):598-603. PubMed PMID: 17113190.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - A randomized, open-label trial of continuous versus interrupted etanercept therapy in the treatment of psoriasis. AU - Moore,Angela, AU - Gordon,Kenneth B, AU - Kang,Sewon, AU - Gottlieb,Alice, AU - Freundlich,Bruce, AU - Xia,H Amy, AU - Stevens,Seth R, Y1 - 2006/11/17/ PY - 2006/01/23/received PY - 2006/08/30/revised PY - 2006/09/05/accepted PY - 2006/11/23/pubmed PY - 2007/3/30/medline PY - 2006/11/23/entrez SP - 598 EP - 603 JF - Journal of the American Academy of Dermatology JO - J Am Acad Dermatol VL - 56 IS - 4 N2 - BACKGROUND: Although etanercept is used as a continuous therapy for moderate to severe plaque psoriasis, intermittent use may be necessary in some instances. OBJECTIVE: In this randomized, open-label study, we evaluated the effectiveness and safety of continuous versus interrupted etanercept therapy. METHODS: All patients received uninterrupted etanercept 50 mg twice weekly during the first 12 weeks, followed by either continuous (n = 1272) or interrupted (n = 1274) etanercept 50 mg once weekly in the next 12 weeks. The primary effectiveness end point was the proportion of responders (those who achieved a Physician's Global Assessment [PGA] score <or=2 and improvement from baseline) at week 24. Secondary end points included the PGA "clear/almost clear" status, the PGA Scalp Psoriasis score, and the Dermatology Life Quality Index. A modified intent-to-treat analysis was performed. RESULTS: At week 12, comparable high proportions of responders were reported in the continuous (71.3%) and interrupted (72.0%) arms. However, the proportion of responders at week 24 was greater in the continuous group than in the interrupted group (71.0% vs 59.5%; P < .0001). Similar results were observed in secondary end points. The mean number of etanercept doses (1 dose = 50 mg) received by patients in the continuous group was 33.4, compared with 28.0 in the interrupted group. Etanercept was well tolerated in both treatment arms. LIMITATIONS: We examined one round of discontinuation and re-treatment; interrupted therapy provided less total medication to responding patients. CONCLUSIONS: Continuous and interrupted etanercept therapy was effective and generally well tolerated in patients with psoriasis, with greater improvements observed in the continuous arm at week 24. Most patients regained their response after reinitiation of etanercept. SN - 1097-6787 UR - https://www.unboundmedicine.com/medline/citation/17113190/A_randomized_open_label_trial_of_continuous_versus_interrupted_etanercept_therapy_in_the_treatment_of_psoriasis_ DB - PRIME DP - Unbound Medicine ER -